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City of Orono <br />Subdivision Application <br />Street Address: Application # 0 5 --3 \ 'Z..? <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Date Received: 0 -;-2..-\-2..C..'Cb <br />Amount Paid: (_,:,C"Q, oo <br />Staff : f-._,\_ (\CL <br />Fee: (.eOO. o o <br />Renewal: <br />This application form must be completed in full. <br />PROPERTY INFORMATION: // <br />Site Address: ,i.(Ot) -r ,y' /{) IJ :r C X'i-1-ff;AI t<J <br />Property Identification Number (PIN): # ;::3117 g::1.s2. liJt>t:, .'5'" -~ rr ;z-:3 /1 'J .2 ~a :z Oo 5'-~ <br />(Attach legal description to application if not included on the survey.) <br />"Date Property Acquired (month/year): AU Ci / c1 ~ 2. ,D( Abstract or □ Torrens, please check one <br />Present use of property: □ Residential I fisOther _,_/\-'-'-c_()_,_f_<:_,~'--'r'--. .1: ___ a111_·__,1q"""t-=------------ <br />/ <br />Zoning District: _ __,__>t_.-"S=------- <br />APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: ( $Ee n-TTf/CH<£/.J) <br />Phone (home): '"15hone (work): <br />Address: <br />Email: ___________________ Fax: <br />OWNER INFORMATION: (Complete legal names and arital status required for each interested party) <br />Name: · 0Ec /! T r::r·~1 'G'I(') <br />Phone (home): '---Phone (work): <br />Address: <br />Email: Fax: ------------------EXISTING LAND USE: _,;, <br />Number of Tax Parcels: z. <br />Development Size: ----Acres Dry Land <br />Acres Wet Land ----,,/ Acres TOT AL, all parcels ---'---- <br />,W Residential; Number of Units: Present Use (check one) <br />Present Zoning District <br />:s' Other: (Specify) /.(l=-ct<?.t:/1-f_r;>ti.J,-:JL. ----------------------{?-. :s ., <br />Proposal: <br />□ Division for Tax Purposes <br />Ef Lot Line Rearrangement Only (no new building sites) <br />□ Subdivision for New Building Sites <br />Number of Building Sites £-· Existing Units <br />New Units <br />Proposed Gross Density <br />Minimum Lot Size <br />Proposed Use ( check) <br />-----Total Units -----__ --'/_. __ Units per ___ Acres <br />-----Square Feet Dry Buildable Land <br />□ Residential <br />□ Other (specify) <br />-10 - <br />--~